Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Blue Lakes Gastroenterology PLLC

Organization Nurse Practitioner · NPI 1821299553

Blue Lakes Gastroenterology PLLC provides Nurse Practitioner services in Twin Falls, Idaho. Registered with an NPI since 2007.

In the registry since
2007
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

775 Pole Line Rd W Ste 203
Twin Falls, ID 83301-5814 Not confirmed with CMS for 13 years — call before visiting
Phone: (208) 814-8300
Fax: (208) 733-8970
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X

Record details

NPI number1821299553
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Ward — Physician · (208) 814-8300
NPI enumeratedMay 30, 2007
Last updated in NPPESMarch 9, 2013
Mailing address775 Pole Line Rd W, Suite 203, Twin Falls, ID 83301-5814

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